Robotic percutaneous device wiper

ABSTRACT

A robotic catheter system including a first drive mechanism configured to interact with an elongated medical device to cause the elongated medical device to move along its longitudinal axis. A controller provides a signal to a motor to move the first wiping surface toward the longitudinal axis when the elongated device is being withdrawn from a patient.

CROSS-REFERENCE TO RELATED PATENT APPLICATIONS

This application is a continuation of U.S. application Ser. No.16/847,078, filed Apr. 13, 2020, which is a continuation of U.S.application Ser. No. 15/785,366, filed Oct. 16, 2017, now U.S. Pat. No.10,653,863, which is a continuation-in-part of U.S. application Ser. No.14/216,076, filed Mar. 17, 2014, now U.S. Pat. No. 9,789,285, whichclaims the benefit of U.S. Provisional Application No. 61/792,353, filedMar. 15, 2013 and incorporated herein by reference in its entirety.

BACKGROUND

Guide wires are used to facilitate percutaneous procedures in which theguide wire is threaded into a human patient using X-ray guidance. Theguide wires are manually threaded by physician or other medicalpersonnel but this requires that the operator be adjacent to the patientand so be in the immediate vicinity of the X-ray radiation providing theimage used for guidance. Systems have been developed, such as thatdisclosed in U.S. Pat. No. 7,887,549 incorporated herein by reference intheir entireties, which allow the guide wires to be threaded into thepatient robotically and thus allow the user or operator to be remotefrom the patient and the X-ray radiation. When the guide wire has beenthreaded into a blood vessel of a human patient it may be becomecontaminated with blood and if it is threaded into some other type ofvessel it may become contaminated with some other bodily fluid. In thecourse of a procedure involving a guide wire it may become useful ornecessary to withdraw it through the Y-connector and/or hemostasisvalve.

SUMMARY

In one embodiment a robotic catheter system includes a first drivemechanism driving a first percutaneous device along its longitudinalaxis. A wiper assembly includes a first wiping engaging an outer surfaceof the percutaneous device along its longitudinal axis as the firstpercutaneous device moves relative to the wiper along its longitudinalaxis. A controller provides a signal to a motor to engage the wipingsurface with the outer surface of the percutaneous device while theelongated device is being withdrawn from a patient.

In one embodiment a robotic catheter system including a first drivemechanism configured to interact with an elongated medical device tocause the elongated medical device to move along its longitudinal axis.A wiper assembly includes a first wiping surface moving toward and awayfrom the longitudinal axis. A controller provides a signal to a motor tomove the first wiping surface toward the longitudinal axis when theelongated device is being withdrawn from a patient

In another embodiment a wiping mechanism associated with a Y-connectorand/or hemostasis valve wipes any bodily fluids which have becomeattached to the surface of a guide wire during its passage into a humanpatient as the guide wire is retracted before it enters or exits theY-connector and/or hemostasis valve.

In a further embodiment, a method of cleaning an elongated medicaldevice includes providing a first drive mechanism configured to interactwith an elongated medical device to cause the elongated medical deviceto move along its longitudinal axis. A wiper assembly is provided havinga first wiping surface moving toward and away from the longitudinalaxis. The method further includes providing a control signal to a motorfrom a remote controller to move the first wiping surface toward thelongitudinal axis of the elongated device when the elongated device isbeing withdrawn from a patient. The method also includes wiping fluidfrom an outer surface of the elongated medical device as the elongatedmedical device is begin withdrawn from the patient.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a schematic view of a wiper system proximate a hemostasisvalve.

FIG. 2 to a top plan view a wiper system proximate a channel for anelongate medical device.

FIG. 3 is top view of a wiper mechanism at a distal portion of acassette.

FIG. 4 is a view of the wiper mechanism intermediate a cassette and aY-connector and hemostasis valve.

FIG. 5 is a cross sectional view of the wiper mechanism of FIG. 4 .

FIG. 6 is an isometric view of a roller wheel that rotates about an axisperpendicular to a longitudinal axis of an elongated medical device.

FIG. 7 is a schematic view of a robotic percutaneous system with a wiperpositioned before the juncture.

FIG. 8 is a schematic view of a robotic percutaneous system with a wiperpositioned proximal the juncture and distal the guide wire drive.

FIG. 9 is a schematic view of a robotic percutaneous system with a wiperpositioned proximal the juncture and between the linear guide wire driveand the rotational guide wire drive.

FIG. 10 is a cross sectional view of the wiper material for multiplepercutaneous device wiper.

FIG. 10A is a cross sectional view of a wiper material for multiplepercutaneous device wiper.

FIG. 11 is a cross sectional top view of a wiper system separatingmultiple percutaneous devices.

FIG. 12 is a schematic view of a dual wiper system for an over the wiresystem.

FIG. 13 is a schematic view of a discrete motion wiper system.

FIG. 14 is a schematic view of a wiper module with a wiper elementengaged with a flexible percutaneous device.

FIG. 15 is the schematic view of a wiper module with a wiper elementdisengaged with a flexible percutaneous device.

FIG. 16 is a schematic view of a wiper module for a first percutaneousdevice being removably inserted into a second percutaneous device.

FIG. 17A-17E are a schematic view of wiper materials.

DETAILED DESCRIPTION

Referring to FIG. 1 a robotic system for manipulating an elongatedmedical device includes a bed side station 12 proximate a bed 22. Aremote-control station 14 includes a controller 16 having a user input18 to control the bed side station 12. An x-ray source 24 is used in aFluoroscopy system to provide an image of on a display 20 in remotestation 14. A robotic system such as that described in U.S. Pat. No.7,887,549 and/or the system described in and U.S. patent applicationU.S. Ser. No. 15/029,115 both of which are incorporated herein in theirentireties may be used in conjunction with the wiper mechanism describedherein. However, it is also contemplated that any drive system used torobotically drive a flexible percutaneous device currently known in theart or later developed may also be used in combination with the wipersystems described herein.

Referring to FIG. 2 a wiping mechanism or wiping assembly 32 may bepositioned between a cassette 26 that is part of operatively connectedto bed side station 12 and Y-connector and/or hemostasis valve and guidecatheter. A guide wire 28 and/or working catheter 30 may be subject towiping mechanism 32 that is deployed between the human patient and theY-connector such that it contacts the surface of the guide wire orworking catheter as it is retracted from a patient and before itinteracts with the drive mechanisms of the cassette 26.

Referring to FIG. 3 a wiping mechanism assembly 36 having a wipingmaterial 58 is positioned between the cassette 26 and the Y-connectorand/or hemostasis valve assembly 44. The assembly 44 includes aY-connector 48 having at least two legs with each having a lumen influid communication with one another. A hemostasis valve 46 isoperatively connected to one of the legs of the Y-connector 48.

Referring to FIG. 4 in one embodiment wiping mechanism 36 is positionedwithin cassette 26 and intermediate a juncture 64 and the hemostasisvalve assembly 44. Cassette 26 includes a first channel 40 through whichguide wire 28 is operatively driven along its longitudinal axis and asecond channel 42 through which a working catheter such as a ballooncatheter or stent catheter is linearly driven along its longitudinalaxis. Wiping mechanism 36 includes a first and second wipers 58 thatmove toward and away from the longitudinal axis of channel 40 tooperatively engage and wipe the outer surface of guide wire 28.

Referring to FIG. 5 wiper assembly includes a resilient material 58configured to wipe the outer surface of a guide wire being retractedfrom a patient into cassette 26 with a drive mechanism. Resilientmaterial may be absorbent and act to wick and or wipe away fluid fromthe guide wire and/or working catheter as each is being withdrawn fromthe patient. Resilient material maybe mounted to two separate pads thatare respectively attached to a first arm 50 and a second arm 52.

Arms 50 and 52 are operatively connected through linkages 54 that may besecured to a gear to drive 56. In this manner rotation of drive 56causes the resilient opposing materials 58 to move toward and/or awayfrom one another. The resilient pads may be robotically moved away fromone another as the guide wire and/or working catheter are inserted intoa patient to minimize friction to the guide wire and/or working catheteras these elongated medical devices are being inserted into a patient.The resilient pads may be robotically moved away from one another as theguide wire and/or working catheter is being withdrawn from a patient andwithdrawn through the Y-connector and/or hemostasis valve.

In one embodiment the wiping mechanism involves two v-shaped members ofa resilient material. In one embodiment these resilient members areconnected to a mechanism which holds them out of contact with the guidewire when it is being fed forward into the human patient but whichbrings them into contact with the guide wire when it is being retractedinto the Y-connector and/or hemostasis valve. In one embodiment thesemembers are constructed of or carry an absorbent material such asnatural or synthetic sponge such that they can absorb the bodily fluidwhich they wipe from the surface of the guide wire. In anotherembodiment an absorbent material is placed beneath or around thesewiping members to absorb the bodily fluid which is wiped from thesurface of the guide wire. In a further embodiment an aspirationapparatus is provided which aspirates the bodily fluid as it is wipedfrom the guide wire surface.

In another embodiment air may be blown over the guide wire proximate theresilient by an air curtain. In one embodiment a wiping fluid isprovided by nozzles directed at the guide wire and activated when it isretracted to clean the guide wire. In this embodiment absorbent materialmay be provided beneath or around the guide wire to absorb the bodilyfluid wiped from the guide wire by the stream of directed fluid. Inanother embodiment the directed fluid is air and/or a liquid and/orspray and the bodily fluid which it wipes from the guide wire isaspirated by a suction mechanism placed in the vicinity of the locationon the guide wire where the air stream impinges on the wire. In oneembodiment air may be directed about the percutaneous device to removeforeign particulate. In one embodiment air may be directed about theouter circumference of the precautious device to dry any liquid that wasused to clean the percutaneous device as described herein. In a furtherembodiment, resilient material is attached to or part of roller wheelsthat rotates about an axis that is perpendicular to the longitudinalaxis of the guide wire and/or working catheter. The rotation of theroller wheels minimizes the friction of the resilient wiping materialwith respect to the guide wire and/or working catheter. In oneembodiment the wheel is driven by a motor when the elongated medicaldevice is being withdrawn. In one embodiment the robotic catheter systemincludes a cleaner 60 depositing a fluid 62 on to the elongated medicaldevice as the medical device is being withdrawn from the patient. In oneembodiment the fluid is deposited by a remote-controlled dispenser 60and the rate of fluid flow is determined by the controller and afunction of one or more of a user input, speed in which the elongatedmedical device is being withdrawn. In one embodiment a sensor 64 shownin FIG. 5 is configured to sense moisture on the wiping surfaces, thesensor providing a signal to a display on a remote station to alert auser that the wiping surface is saturated. In one embodiment thecontroller 16 automatically provides a signal to a motor to move awiping surface away from the elongated medical device when the drivemechanism is driving the elongated medical device into a patient.Referring to FIG. 6 a roller wheel 66 rotates about an axisperpendicular to the longitudinal axis of the elongated medical device38.

Referring to FIG. 7 a cassette 26 as discussed above includes a firstchannel through which a guide wire 28 or other flexible percutaneousdevice is movably driven there along from a proximal end 72 toward endand through a distal end 74 thereof. As used herein the distal end ofguide wire 28 is the free end that is inserted into a vasculature. Theproximal end of guide wire 28 is the free end that is outside of thepatient during a procedure in the vasculature. Similarly, the distal endof the various features and mechanisms is the end that is closer to thedirection that the guide wire moves toward the vasculature and theproximal end is the end or portion that is further from the vasculature.

A working catheter 30 such as a balloon catheter or stent catheter orother catheters known in the art for performing a function within avasculature is movable driven along a second channel 42. First channel40 and second channel 42 intersect at a juncture 64. In one embodimentfirst channel 40 has a longitudinal axis that is not co-linear with alongitudinal axis of channel 42. In one embodiment a first wiperassembly 76 is positioned adjacent channel 40 on the proximate side ofjuncture 64. Stated another way first wiper assembly 76 is positionedbetween juncture 64 and the proximal end 72 of cassette 26. First wiperassembly 76 operatively engages and disengages guide wire 28 as guidewire 28 is moved relative to first wiper assembly 76 along thelongitudinal axis of guide wire 28. In one embodiment first wiperassembly moves a wiper element about the longitudinal axis of guide wire28 such that it rotate about the outer surface of the guide wire. In oneembodiment first wiper assembly moves both along the longitudinal axisof guide wire 28 and about the outer surface of the guide wire. In oneembodiment a second wiper assembly 78 is positioned proximate channel 42to wipe the outer surface of a working catheter 30 along thelongitudinal axis of the working catheter as the working catheter ismoved relative to the wiper assembly 78. As described herein below wiperassembly may move along the longitudinal axis of the working catheter ormay be stationary as the working catheter 30 moves along itslongitudinal axis as the working catheter 30 is moved in and/or out ofthe vasculature.

Referring to FIG. 8 in one embodiment wiper assembly 76 is positionedproximal a drive mechanism 80 that drives the guide wire 28 along itslongitudinal axis into and out of the vasculature. Stated another waywiper assembly 76 is positioned between juncture 64 and linear drivemechanism 80. In one embodiment wiper assembly 78 is positioned betweenjuncture 64 and linear drive mechanism 82 that drives working catheter30 along its longitudinal axis.

Referring to FIG. 9 in one embodiment wiper assembly 76 is positionedbetween distal linear drive 80 or stated another linear drive 80 ispositioned between juncture 64 and wiper assembly 76. In one embodimenta drive 84 is positioned distal wiper assembly 76. Stated another waywiper assembly is positioned between linear drive and drive 84. In oneembodiment drive 84 is a rotational drive mechanism that rotationallydrives guide wire 28 about its longitudinal axis. In one embodimentdrive 80 and drive 84 are part of a linear drive system that provideslinear movement to the guide wire to move guide wire 28 in and out ofthe vasculature. In one embodiment drive 80 and drive 84 are part of adrive system that provides both linear and rotational drive to guidewire 28. In one embodiment drive 80 and drive 84 are part of a drivesystem that provides linear drive to guide wire 28.

Referring to FIG. 10 wiper material 86 includes a wiper that may be usedas wiper material is wiper mechanism 36 or in any other wiper at ordistal juncture 64 in which both guide wire 28 and catheter 30 are wipedby a wiper assembly 36. In one embodiment wiper material 86 includes afirst wiper 88 and a second wiper 90 that moves toward and away fromeach other to engage guide wire 28 and catheter 30. First wiper 88 andsecond wiper 90 each include a first portion 94 and a second portion 92that engage respectively guide wire 28 and catheter 30. First portions94 include a wiping surface 96 and second portion 92 include a wipingsurface 98. When first wiper 88 and second wiper move toward each othersurfaces 96 of first portions 94 are closely adjacent one another indirect contact with guide wire 28. In one embodiment surfaces 96 aresufficiently pliant such that surfaces 86 surround guide wire 28 aboutits circumference to wipe the entire outer surface of guide wire 28 asguide wire 28 moves relative to wiping mechanism 36 or 76 or 78 alongits longitudinal axis.

Referring to FIG. 10A a wiper system 36 may include a material 100 thatincludes a first member 102 and a second member 104 that move toward andaway from one another toward the longitudinal axis of guide wire 28 andcatheter 30. Each member 102 and 104 include a first recess 106 toreceive the outer surface of guide wire 28 and a second recess 108 toreceive the outer diameter of catheter 30. In one embodiment recess 106and recess 108 have a radius that is equal to the radius of guide wire28 and catheter respectively. In one embodiment recess 106 and recess108 have a radius that is less than the radius of guide wire 28 andcatheter 30 respectively. In one embodiment recess 107 and recess 108 ismade of a pliant material that forms fully engages the entire outercircumference of a portion of guide wire 28 and catheter 30respectively. In this manner the entire outer surface of guide wire 28and catheter 30 are wiped as the guide wire 28 and catheter 30 moverelative to the wiper system 36 along their longitudinal axis.

In one embodiment surfaces 96, 98 or 106,108 are a distance apart sothat that they form a first region and a second region respectivelyhaving different distances between the two to accommodate differentdiameter sized guide wire and flexible percutaneous devices.

Referring to FIG. 11 a wiper system 110 includes a cassette 26operatively linearly driving guide wire 28 and catheter 30 along theirlongitudinal axis through a wiper system 112 having a first wiper 116and a second wiper 114. Where first wiper 116 wipes guide wire 28 andsecond wiper 114 wipes catheter 30 as the guide wire and catheter 30move along their respective liner axis relative to the first wiper 116and second wiper 114. Each wiper 116 and 114 include wiper elements asdescribed herein. A diverter 118 and 120 operatively guides guide wire28 and catheter 30 to respective first wiper 116 and second wiper 114 asthe guide wire 28 and catheter 30 are moved along their longitudinalaxis where first wiper 116 and second wiper 114 are located intermediatejuncture 64 and the y-connector 48 and/or hemostasis valve 44. In oneembodiment a guide catheter 142 is positioned on the distal end 122 ofthe y-connector. The guide wire 28 and catheter 30 being moved within alumen 144 of the guide catheter by a drive mechanism in cassette 26. Inone embodiment FIG. 11 is not to scale and the separation of guide wire28 and catheter is minimal and just sufficient to align the guide wireand catheter within the recesses formed by features 106 and 108 asdescribed herein.

Referring to FIG. 12 a wiper system 130 for a guide wire and catheterincludes a housing 132 including a wiper 134 and a drive 136. This wipersystem is used on an over the wire device in which catheter 30 extendsover guide wire 28. In this over the wire system wiper 134 includes oneof the wiper materials as described herein. In one embodiment a holderor seal 138 operatively positions a proximal end 140 of catheter 30within housing 132. Housing 132 supports guide wire drive 136 and guidewire wiper 134. A catheter drive 150 moves catheter 30 along itslongitudinal axis toward and away from y-connector 48. As the proximalend 140 of catheter 30 moves away from y-connector 48 housing 132 movesalong with proximal end 140 away from y-connector as well. A catheterwiper 152 operatively is fixed in location relative to y-connector 48and wipes the outer surface of catheter 30 as proximal end 140 is movedaway from y-connector 48. As housing 132 moves away from y-connector 48linear drive 136 moves guide wire 28 toward y-connector 48 at the samespeed as housing 132 moves away from y-connector 48 such that guide wire28 is stationary with respect to y-connector 48. Since housing 132 ismoving away from y-connector 48 and guide wire 28 is remainingstationary with respect to y-connector 48 wiper 134 will wipe the outersurface of guide wire as housing 132 moves away from the y-connector.

While system 130 has been described with respect to a guide wire 28 anda catheter having a lumen receiving the guide wire therein, the systemwould also work if guide wire 28 were another catheter. In oneembodiment another catheter could be in its own housing with a wiper anddrive intermediate guide wire housing 132 and catheter 30. Statedanother way the system would work with multiple telescoping catheterdevices.

Referring to FIG. 16 a wiper system 150 includes a housing 152supporting a wiper 154 and a holder 162 for holding a distal end 164 ofcatheter 30. Wiper system 150 is used in one embodiment for a rapidexchange catheter that rides along the guide wire 28 on a mono-rail typesupport as is known in the art. A guide wire manager includes a movableguide 158 that includes one or more elements that manage the entirelength of the guide wire 28 extending from the y-connector 48 to theproximate end 166 of the guide wire. Guide 158 moves toward and awayfrom a longitudinal axis of guide wire 28 when guide wire 28 is coaxialwith a lumen of a leg 168 of y-connector to move any bucking portion orextra length of guide wire out of the way of loader 152. In oneembodiment guide 158 moves a portion of guide wire 28 in a directionaway from the direction of gravity. In one embodiment guide 158 moves aportion of guide wire 28 in a direction perpendicular to the directionof gravity. In one embodiment guide 158 removably positions a portion ofthe guide wire in a holder. A brake 160 holds a portion of guide wire ina fixed position relative to y-connector 48 and the portion of guidewire 28 between drive 156 is moved out of the way of an axis extendingbetween drive 156 and y-connector leg 168 such that proximal end 166 ispositioned within the rapid exchange portion loader 152. A linear drive156 drives proximal end 166 of guide wire 28 away from y-connector 48toward and into engagement with distal end 164 of catheter 30. A wiper154 wipes the outer periphery of guide wire 28 as described herein. Asguide wire 28 is moved away from y-connector 48 guide 158 moves toward alongitudinal axis defined by leg 168 of y-connector until the guide wireis on the same longitudinal axis as leg 168. Guide 158 then moves out ofthe way to allow catheter 30 to be driven along guide wire 28 throughy-connector 48 and into guide catheter 142.

In one embodiment guide wire 28 is fully inserted into catheter 30 suchthat the longitudinal axis of the guide wire 28 is co-linear with thelumen of leg 168 of Y-connector 48. In this manner guide 158 is movedout of the way of the longitudinal axis of the guide wire 28. Once guidewire 158 is fully inserted within catheter 30 if it is an over the wirecatheter or fully extended if a rapid exchange catheter such that theproximal end 166 of the guide wire is furthest from Y-connector wiper154 engages the outer surface of the guide wire and housing 152 is movedalong the longitudinal axis of guide wire 28 in a direction away fromy-connector 48 such that the wipers of wiper 154 wipes the outer surfaceof the guide wire.

Referring to FIG. 14 and FIG. 15 . A wiper system 170 includes wiperelements 172 that operatively engage and wipe catheter 30 but could alsobe used to operatively engage and wipe guide wire 28. A fluid 174 isintroduced through a conduit 176 into wiper housing 180 and flows aroundthe outer periphery of catheter 30 and exits through a drain conduit178. Catheter 30 is wiped by elements 172 as catheter 30 is moved awayfrom the y-connector and cleaned by fluid 174. Referring to FIG. 15 .wiping elements 172 move away from catheter 30 as catheter is driven bya drive mechanism toward and through y-connector 48 into guide catheter142. In one embodiment wipers 172 are not moved but operate to only wipecatheter 30 as it moves in one direction. In one embodiment wiperelements 172 only wipe when the catheter 30 is moved in a direction awayfrom the y-connector. In one embodiment wiper elements 172 only wipecatheter 30 when the catheter is moved in a direction toward they-connector. In one embodiment wiper element or elements wipe catheter30 both when the catheter is moved away from the y-connector and movedtoward the y-connector. In one embodiment housing 180 does not includefluid cleaning feature. In one embodiment housing 180 moves back andforth along the longitudinal axis of catheter 30.

In one embodiment the rate of fluid introduced into the cavity of thewiper assembly is robotically controlled based on the length ofpercutaneous device cleaned and the rate in which the percutaneousdevice moves through the wiper assembly. In one embodiment, fluid isintroduced when the percutaneous device is stationary to clean the wipersurfaces. A flutter valve or umbrella valve may be used to control theflow of the fluid within the wiper assembly. In one embodiment the fluidis introduced at a pressure greater than that of gravity. In oneembodiment the fluid is introduced as a high velocity flow or spray. Inone embodiment the fluid is introduced in a pulsating means. In oneembodiment the fluid forms a bath about the circumference of thepercutaneous device within the wiper assembly. In one embodiment thefluid is ultrasonically agitated to aid in the cleaning of thepercutaneous device and/or wipers. In one embodiment the fluid may beheated above room temperature.

Referring to FIG. 13 a wiper system 190 includes a movable a drive 192that has a releasable gripper 192 that releasable engages guide wire 28or catheter 30. Referring to FIG. 13 gripper 192 operatively grips guidewire 28 and moves toward y-connector 48 moving guide wire 28 a distancetoward y-connector 48. This is illustrated in FIG. 13 as a point A onguide wire 28 being moved a distance 196. Gripper 192 then releasesguide wire 28 and gripper portions move away from the longitudinal axisof guide wire 28. Wiper elements 194 that were disengaged from guidewire 28 are now moved into wiping engagement with guide wire 28 in adirection toward the longitudinal axis of guide wire 28. Drive 192 movesin a direction away from y-connector while wiping elements wipe theouter surface of guide wire 28. Once drive 192 moves away fromy-connector a distance 196 the wiping element disengage from the outersurface of guide wire 28 and gripper 192 moves toward the longitudinalaxis of guide wire 28 gripping the guide wire 28. The process thenrepeats. In one embodiment wiper elements 194 are directly connected togripper 192. In one embodiment wiper elements 194 is in its own housingand moves independent of gripper 192 by a separate motor drive system.In one embodiment wiper elements 194 is similar to wiper system 170where wiper system 170 moves and wipes as indicated herein in a stepwise discrete manner. In one embodiment a releasable gripper holder notshown is used to secure the guide wire as the wiper elements arecontacting and wiping the outer surface of the guide wire 28 to ensurethat the guide wire does not move along with the wiper elements in adirection along the longitudinal axis of the guide wire.

Referring to FIG. 17 various wiper elements are for use in any of thewiper systems described herein. Referring to FIG. 17A a duck bill pairof elements 200 engage guide wire 28 or catheter 30 (percutaneousdevice) by having a pair of flexible members contacting the outersurface of the percutaneous device. Elements have some spring forceassociated with them such that the terminal ends of the wiper elementsremain engaged with the outer surface of the percutaneous device. In oneembodiment a second pair of duck bill elements 200 are arranged in anopposing orientation to provide wiping of the percutaneous device whenthe percutaneous device is being moved along its longitudinal axis in asecond direction opposite the first direction.

Referring to FIG. 17C a flexible micro lip seal effectively wipespercutaneous device 30 as it moves both toward and away from y-connectoralong its longitudinal axis. Seal 220 being sufficiently flexible wiperto bend in the direction of movement of the percutaneous device.

Referring to FIG. 17D a plurality of flexible fingers or bladesoperatively engage the outer surface of the percutaneous device toprovide multiple wiping elements to act on the outer surface of thepercutaneous device. Referring to FIG. 17 a flexible bellow member 240includes a lip portion 242 that extends from a base portion 244 as thepercutaneous device moves along its longitudinal axis. Bellow housingmember 240 expands in a direction of travel of the percutaneous device.In one embodiment one of the wiper elements as described herein providesan ultrasonic vibration to the percutaneous device sufficient to shedliquid and foreign material from the percutaneous device either alone orin combination with the mechanical wiping of the wiping members. In oneembodiment a vacuum is applied to the exit or drain 178 to remove liquidfrom the wiper assembly 170.

Referring to FIG. 17E split wiper members moves radially toward and awayfrom the longitudinal axis of the percutaneous device 30. The splitwiper members may include 2, 3 4 or more members that are moved towardand away from the percutaneous device to effectively wipe the entirecircumference of the percutaneous device.

In one embodiment a wiper rotates about the circumference of thepercutaneous device and has a wiping surface that removable engages theouter surface of the percutaneous device. In one embodiment the rotarywiper is in a housing that in addition to rotating about thecircumference of the percutaneous device also moves relative to thepercutaneous device along the longitudinal axis of the percutaneousdevice. In one embodiment both the percutaneous device and wiper housingthat supports moves relative to the Y-connector and the

In one embodiment a wiping mechanism is robotically controlled movingthe wiper toward and away from the moving percutaneous devices. In oneembodiment a wiping member may be robotically controlled in a hemostasisvalve such as that shown in FIG. 29 and FIG. 30 of co-pending U.S.application Ser. No. 15/029,115 in which the hemostasis valve iscontrolled remotely from a user interface. The hemostasis valve may bemodified and or another valve may be placed between the hemostasis valve44 and cassette 26. Stated another way wiper assembly 36 includes arobotic controlled hemostasis valve shown in FIG. 29 and FIG. 30 of U.S.patent application Ser. No. 15/029,115 in which the valve is a wiperassembly that is robotically controlled by rotation of the outerhousing. In one embodiment the system includes a controller thatautomatically engages the wiper with the percutaneous valve uponretraction of a device. In one embodiment the system automaticallyengages a wiper member upon retraction of a device for more than apredetermined time period and/or predetermined distance.

In one embodiment the user interface includes a wiper control button toprovide instructions to the wiper systems to engage and wipe onepercutaneous device and/or all the percutaneous devices. In oneembodiment a signal is sent to the motors providing the retraction forceto increase the force to overcome the friction that results from thewipers engaging the outer surface of the one or more percutaneousdevices being wiped. In one embodiment the wiper materials are formedfrom a hydrophobic material and provides a squeegee action to removeforeign matter from the percutaneous device. In one embodiment thewiping material is a hydrophilic material that absorbs liquid from thepercutaneous device. In one embodiment a sensor may send a portion ofthe wiping material for wetness and provide an alert to the user via auser interface to change replace the wipers and/or to automatically washthe wipers in a fluid rinse as described herein.

It is contemplated that the various wiping elements and features of thewiping system be interchangeable with the various systems describedherein. In one embodiment Guide wire 28 and catheter 30 are flexibleelongated medical devices and are generically referred to herein aspercutaneous devices. However other elongated medical devices that areflexible or rigid or in between known in the art are herein referred toas percutaneous devices.

Further modifications and alternative embodiments of various aspects ofthe invention will be apparent to those skilled in the art in view ofthis description. Accordingly, this description is to be construed asillustrative only and is for the purpose of teaching those skilled inthe art the general manner of carrying out the invention. Any of thefeatures, elements, or components of any of the exemplary embodimentsdiscussed above may be used alone or in combination with any of thefeatures, elements, or components of any of the other embodimentsdiscussed above. It is to be understood that the forms of the inventionshown and described herein are to be taken as presently preferredembodiments. Elements and materials may be substituted for thoseillustrated and described herein, parts and processes may be reversed,and certain features of the invention may be utilized independently, allas would be apparent to one skilled in the art having the benefit ofthis description of the invention. Changes may be made in the elementsdescribed herein without departing form the spirit and scope of theinvention as described in the following claims.

1.-20. (canceled)
 21. A robotic catheter system, the system comprising:a first drive mechanism configured to move a first elongated medicaldevice disposed within a lumen of a second elongated medical devicealong a longitudinal axis of the first elongated medical device; aholder to secure a proximal end of the second elongated medical device;a first wiper assembly disposed between the holder and the first drivemechanism, in a fixed position with respect to the holder, andconfigured to wipe the first elongated medical device; a second wiperassembly configured to wipe the second elongated medical device; and asecond drive mechanism disposed between the holder and the second wiperassembly, the second drive mechanism configured to move the proximal endof the second elongated medical device along its longitudinal axis awayfrom the second wiper assembly, causing the holder and the first wiperassembly to move away from the second wiper assembly, wherein the firstdrive mechanism is configured to maintain the first elongated medicaldevice substantially stationary with respect to the second wiperassembly while the second drive mechanism moves the proximal end of thesecond elongated medical device along its longitudinal axis away fromthe second wiper assembly.
 22. A system according to claim 21, whereinthe first elongated medical device is wiped by the first wiper assemblyand the second elongated medical device is wiped by the second wiperassembly while the proximal end of the second elongated medical devicemoves along its longitudinal axis away from the second wiper assemblyand the first elongated medical device remains substantially stationarywith respect to the second wiper assembly.
 23. A system according toclaim 22, further comprising: a housing to which the holder and thefirst wiper assembly are fixed, and wherein movement of the proximal endof the second elongated medical device along its longitudinal axis awayfrom the second wiper assembly causes movement of the housing away fromthe second wiper assembly.
 24. A system according to claim 23, whereinthe first drive mechanism is fixed to the housing.
 25. A systemaccording to claim 21, further comprising: a housing to which the holderand the first wiper assembly are fixed, and wherein movement of theproximal end of the second elongated medical device along itslongitudinal axis away from the second wiper assembly causes movement ofthe housing away from the second wiper assembly.
 26. A system accordingto claim 25, wherein the first drive mechanism is fixed to the housing.27. A method comprising: operating a first drive mechanism to move aproximal end of a first elongated medical device along its longitudinalaxis away from a first wiper assembly to cause wiping of the firstelongated medical device by the first wiper assembly, where movement ofthe proximal end causes movement of a second wiper assembly away fromthe first wiper assembly; and operating a second drive mechanism, whilethe first drive mechanism moves the proximal end of the first elongatedmedical device along its longitudinal axis away from the first wiperassembly, to maintain a second elongated medical device disposed withina lumen of the first elongated medical device substantially stationarywith respect to the first wiper assembly, to cause wiping of the secondelongated medical device by the second wiper assembly.
 28. A methodaccording to claim 27, further comprising: securing the proximal end ofthe first elongated medical device to a housing to which the secondwiper assembly is fixed, wherein movement of the proximal end of thefirst elongated medical device along its longitudinal axis away from thefirst wiper assembly causes movement of the housing and the second wiperassembly away from the first wiper assembly.
 29. A method according toclaim 28, wherein the second drive mechanism is fixed to the housing.30. A method according to claim 27, wherein operating the second drivemechanism to maintain the second elongated medical device substantiallystationary with respect to the first wiper assembly comprises operatingthe second drive mechanism to bias the second elongated medical devicetoward the first wiper assembly.
 31. A robotic catheter system, thesystem comprising: a first drive mechanism configured to move a firstelongated medical device disposed within a lumen of a second elongatedmedical device along a longitudinal axis of the first elongated medicaldevice; a holder to secure a proximal end of the second elongatedmedical device; a first wiper assembly disposed between the holder andthe first drive mechanism and configured to wipe the first elongatedmedical device; a hemostasis valve to receive the second elongatedmedical device; a second wiper assembly disposed between the hemostasisvalve and the holder, and configured to wipe the second elongatedmedical device; and a second drive mechanism disposed between thehemostasis valve and the holder, the second drive mechanism configuredto move the proximal end of the second elongated medical device alongits longitudinal axis away from the second wiper assembly, causing theholder and the first wiper assembly to move away from the hemostasisvalve, wherein the first drive mechanism is configured to maintain thefirst elongated medical device substantially stationary with respect tothe hemostasis valve while the second drive mechanism moves the proximalend of the second elongated medical device along its longitudinal axisaway from the hemostasis valve.
 32. A system according to claim 31,wherein the first elongated medical device is wiped by the first wiperassembly and the second elongated medical device is wiped by the secondwiper assembly while the proximal end of the second elongated medicaldevice moves along its longitudinal axis away from the hemostasis valveand the first elongated medical device remains substantially stationarywith respect to the hemostasis valve.
 33. A system according to claim32, further comprising: a housing to which the holder and the firstwiper assembly are fixed, and wherein movement of the proximal end ofthe second elongated medical device along its longitudinal axis awayfrom the hemostasis valve causes movement of the housing away from thehemostasis valve.
 34. A system according to claim 33, wherein the firstdrive mechanism is fixed to the housing.
 35. A system according to claim31, further comprising: a housing to which the holder and the firstwiper assembly are fixed, and wherein movement of the proximal end ofthe second elongated medical device along its longitudinal axis awayfrom the hemostasis valve causes movement of the housing away from thehemostasis valve.
 36. A system according to claim 35, wherein the firstdrive mechanism is fixed to the housing.